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1.
Yutaka Yonemura Masataka Segawa Hisashi Matsumoto Kouichirou Tsugawa Itasu Ninomiya Luis Fonseca Takashi Fujimura Kazuo Sugiyama Kouichi Miwa Itsuo Miyazaki 《Surgery today》1994,24(6):488-493
Because gastric cancers located in the upper third of the stomach are difficult to detect at an early stage, the surgical results remain poor. We performed R4 gastrectomy as a radical procedure for 25 patients, involving complete resection of the latero-aortic and interaorticovenous lymph modes above and below the left renal vein, in combination with the ordinary R2 or R3 gastrectomy (the R4 group). These patients were compared with 156 others who underwent R2 gastrectomy alone (the R2 group). There were no significant differences in operation time, blood loss, or the incidence of complications between the two groups; however, when the survival rates of the patients with tumors invading beyond the subserosa were compared, the 5-year survival rate was found to be significantly higher in the R4 group than in the R2 group. Furthermore, in patients with para-aortic nodal involvement, a significant survival advantage was observed in the R4 group, as compared with the R2 group. These results suggest that the R4 gastrectomy is a rational approach for patients with advanced gastric cancer located in the upper third of the stomach. 相似文献
2.
Masamitsu Endo Kouichirou Kobayashi Makoto Tsubota Masahiro Seki Hideo Sato Tasuku Noto Takashi Iwa 《Surgery today》1996,26(1):1-4
This study was conducted to compare the midline incision right retroperitoneal approach for repairing abdominal aortic aneurysms (AAA) with the transperitoneal approach. The intra- and postoperative course of 15 patients who underwent AAA repair using the transperitoneal approach between 1987 and 1991 and another 15 patients who underwent AAA repair using the retroperitoneal approach between 1991 and 1994 were evaluated. The incidence of postoperative wound complications was also assessed. There was no operative or hospital death in either group. Although a significantly longer interval was required from the incision to the aortic clamp using the extraperitoneal method, there were no statistical differences in the aortic clamping time, total operation time, or blood loss between the two groups. On the other hand, there was a statistically significant improvement in bowel function and a significant reduction in the length of postoperative hospitalization following the extraperitoneal procedure. Furthermore, no wound complications such as those associated with the left flank incision developed after the extraperitoneal procedure. Thus, we recommend the midline incision right retroperitoneal approach for AAA as it does not involve muscle division and is associated with fewer complications. 相似文献
3.
Isao Iwamoto Hisamichi Baba Yasunori Koga Noriyuki Uchida Kazuhiko Matsuo Kiyoshi Ishii Toshio Onitsuka Kouichirou Shibata 《Surgery today》1990,20(2):158-162
In order to assess the accuracy of electroencephalography (EEG), in children who have undergone cardiac surgery under simple
deep hypothermia, the relation between IQ or schoolwork achievement and the duration of circulatory arrest was investigated
in 75 such children. Abnormal preoperative EEG's were found in 16 per cent of the children while abnormal postoperative EEG's
were found in 17 per cent. The children were divided into 4 groups, according to pre- and postoperative EEG results. Schoolwork
achievement scores ranged between 3.0 and 3.2, the difference among the groups being insignificant. Moreover, no significant
shift in IQ was found among the groups. Finally, regarding the number of children who were able to go on to a higher level
of education, including high school the college or university, again no significant differences were found among the 4 groups.
In a comparison with the number of such children in neighboring Nagasaki prefecture able to continue on to a higher level
of education, no significant differences were seen either. The findings and statistics of this investigation therefore indicate
that pre- and postoperative EEG's are not always a reliable reference for assessing the prognosis of cerebral activity. 相似文献
4.
5.
Kuba H Sato N Uchiyama A Nakafusa Y Mibu R Yoshida K Kuroiwa K Tanaka M 《Surgery today》1999,29(4):375-377
We herein describe a patient with mediastinal lymph node metastases which occurred after both a primary sigmoid colon cancer
and metachronous ovarian metastasis had been resected. The most likely route of metastases to the mediastinum in this case
is the paravertebral venous plexus probably connected to the ovarian metastasis, or so-called remetastasis. This case illustrates
that the mediastinum is thus a possible metastatic site in patients with colon cancer. Surgeons should therefore pay attention
to the mediastinum as well as the lung fields when checking chest X-ray films during a follow-up of patients after a resection
of colon cancer. 相似文献
6.
Kouichirou Nishiyama Hajime Hirose Yoshiaki Iguchi Kazuhiro Yamamoto Takashi Masaki Takahiro Kamijo Takeshi Ino Jun Yamanaka Kazuo Yao Makito Okamoto 《Nihon Jibiinkoka Gakkai kaiho》2003,106(3):220-225
To improve low-pitched voices in cases with polypoid vocal cords, YAG laser irradiation combined with a mucosal suturing technique was attempted in 9 female cases with severe polypoid changes in their vocal cords. A YAG laser beam (5 to 10 W) was used to irradiate the upper surface of the polypoid vocal cord. The polypoid content of the cord was gradually coagulated, and the free edge of the cord appeared to slide up toward the burned area. The polypoid content was then removed and squeezed through an open wound made in the burned area using a conventional method. Bleeding was successfully controlled using the laser. After the excessive mucosal margin was trimmed and the contour of the vocal cord was adjusted, the wound was closed by 7-0 monofilament absorbable suture. Suturing was relatively easy because the mucosal edge was also coagulated. Postoperative evaluations of voice quality revealed an improvement in the GRBAS scale of voice quality as well as an elevation in voice pitch and an upwards shift in the voice range in all cases. 相似文献
7.
Kazuhiro Kitajima Shingo Yamamoto Yusuke Kawanaka Hisashi Komoto Kimihiro Shimatani Takeshi Hanasaki Motohiro Taguchi Seiji Nagasawa Yusuke Yamada Akihiro Kanematsu Koichiro Yamakado 《Medicine》2021,100(23)
This study aimed to evaluate the clinical use of choline-PET/CT for discriminating viable progressive osteoblastic bone metastasis from benign osteoblastic change induced by the treatment effect and evaluating the response of bone metastasis to treatment in metastatic castration-resistant prostate cancer (mCRPC) patients. Thirty patients with mCRPC underwent a total of 56 11C-choline-PET/CT scans for restaging, because 4 patients received 1 scan and 26 had 2 scans. Using 2 (pre- and post-treatment) 11C-choline-PET/CT examinations per patient, treatment response was assessed according to European Organization for Research and Treatment of Cancer (EORTC) criteria in 20 situations, in which only bony metastases were observed on 11C-choline-PET/CT scans. Viable bone metastases and osteoblastic change induced by the treatment effect were identified in 53 (94.6%) and 29 (51.8%) of 56 11C-choline-PET/CT scans, respectively. In 27 cases (48.2%), 11C-choline-PET/CT scans could discriminate the 2 entities. The mean SUVmax of the metastatic bony lesions was 5.82 ± 3.21, 5.95 ± 3.96, 6.73 ± 5.04, and 7.91 ± 3.25 for the osteoblastic, osteolytic, mixed, and invisible types, respectively. Of the 20 situations analyzed, CMR, PMR, SMD, and PMD, as determined by the EORTC, were seen in 1, 2, 3, and 14 cases, respectively. Of the 13 patients with increasing PSA trend, all 13 showed PMD. Of the 2 patients with PSA response of <50%, both 2 showed SMD. Of the 5 patients with PSA response of ≥50%, 1 showed CMR, 2 showed PMR, 1 showed SMD, and 1 showed PMD. Choline-PET/CT is very useful to discriminate viable progressive osteoblastic bone metastasis from osteoblastic change, and assess treatment response of bone metastases in mCRPC. 相似文献
8.
A Shibuya T Unuma T Sugimoto M Yamakado H Tagawa K Tagawa S Tanaka R Takanashi 《Gastroenterology》1985,89(1):196-201
A 31-yr-old Japanese woman who was on chronic hemodialysis for 3 yr died of intractable congestive heart failure. Three years before death, the patient was in a state of shock for 48 h due to ventricular tachycardia and gastrointestinal bleeding, which was followed by marked elevation of serum transaminase. Four months later, abdominal plain radiography demonstrated diffuse hepatic calcification. At autopsy, microscopic examination of the liver revealed parenchymal necrosis and tiny calcifications in the central to midzonal area of the lobule. Calcification in the degenerative area of the hepatic lobule occurred subsequent to parenchymal ischemia after overt shock that lasted for 2 days. Although a definitive explanation for the calcification was not obtained, it may be related to the disturbances of intracellular Ca2+ homeostasis as a result of ischemic liver injury or it may be related to an elevated calcium-phosphorus product in the uremic state. 相似文献
9.